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Workers’ Compensation

If you get hurt at on the job, you may be wondering how you will pay for medical expenses, long-term kinds of care such as physical therapy and everyday expenses while you are away from work. Luckily, many working people are able to claim workers’ compensation benefits that help with these costs. By utilizing workers’ compensation benefits, you can access the medical care you need while still drawing at least part of your normal paycheck — allowing you to heal and return to work with fewer worries.

What is Workers’ Compensation?

Workers’ compensation (also called “worker’s comp” or “workman’s comp”) is a common employee benefit for many American workers. This type of insurance benefit is provided by your employer and helps with the costs of medical treatment and care in the event that you are injured at your workplace or a work-related event. Because workers’ compensation is an additional form of insurance, it is a good benefit to have, especially for employees with strenuous or physically demanding jobs that run the risk of injury.

You may wonder why workers’ compensation is a benefit you should sign up for when working through the hiring process with a new employer. Unlike any monthly health insurance premiums that you pay out of pocket, workers’ compensation benefits come at no additional cost to you. Because your employer pays for this kind of insurance coverage, there is no need to worry about footing the bill for additional insurance that you may not ever need to use.

While workers’ compensation generally works by footing the bill medical treatment of work-related injuries, the amount a particular company or insurance provider pays out during your care can vary. This is because each state has its own requirements for workers’ compensation benefits. These regional laws can also impact how much of your paycheck you continue receiving while away from working healing for an injury or the maximum payout in the event you are permanently disabled from a work-related injury or accident.

What Does Workers’ Compensation Cover?

Workers’ compensation coverage varies by industry, employer and individual benefits. In general, workers’ compensation coverage kicks in if you are injured on the job — regardless if it is your fault, the fault of another employee or the company’s negligence — and covers most to all medical expenses related to that injury. In most cases, workers’ compensation benefits will help you with costs such as:
•Medical treatment for your work-related injury or illness
•Financial compensation in the case you are disabled or an injury permanently affects your quality of life or everyday tasks
•Partial to full income coverage for the time you are away from work recovering
•Training or education for a new job or career if you must change industries due to your injury or illness
•Financial compensation to your family or beneficiaries in the event you are killed in a work-related accident

Depending on where you life, state laws can impact the limits of your workers’ compensation coverage. In some states, an employer can deny workers’ compensation benefits if it appears that your injuries are self-inflicted injuries or occurred because you were violating company policy or a law. In many instances, workers who are injured while under the influence of alcohol or other substances may not receive benefits.

And, it should be noted that workers’ compensation does not cover injuries you receive while off the clock. This means that if you get hurt during a weekend, on vacation or any other time away from work, you cannot submit a claim for workers’ compensation. Individuals who attempt to pass off an injury that occurred outside of work as a work-related injury are committing workers’ compensation fraud. In doing so, they risk legal and financial ramifications, such as criminal charges, jail time and heavy fines — and will still be responsible for funding their own medical care for their non-work related injury. Workers’ compensation fraud is a serious issue and a leading reason why employees are often interviewed by human resources managers (along with paperwork) throughout the compensation process.

Who is Covered By Workers’ Compensation?

In most states, all employees are eligible for workers’ compensation benefits regardless of how frequently you work. Whether you work as a seasonal, part-time or full-time employee should not affect your ability to claim workers’ compensation benefits (unless your specific state limits workers’ compensation to only full-time employees).

Your employer may or may not be legally required to provide workers’ compensation benefits for you based on a variety of factors, such as the number people employed by the company and the industry in which you work. In some states such as Missouri, Tennessee and Mississippi, businesses are not required to provide workers’ compensation if they have fewer than five employees. In addition, many farm laborers, agricultural workers and railroad employees may not have access to workers’ compensation coverage if they work in certain areas of the country.

Because of these legal limitations, it is exceptionally important to understand your individual workers’ compensation benefits in the likelihood that you may need to use them.

Does Workers’ Compensation Mean I Can’t File a Lawsuit?

Workers’ compensation exists to provide for your medical and financial needs in the situation of a workplace accident. In some instances, accepting workers’ compensation benefits to pay for your medical needs removes your ability to seek out additional damages in a court of law, even in situations where you believe a company’s negligence led to your injury. Yet, this should not necessarily deter you from utilizing workers’ compensation benefits. If you feel that a particular employee, piece of equipment or other third-party led to your injury, it is still possible to seek damages through a lawsuit.

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WHO SELLS WORKERS COMP INSURANCE?
Workers comp insurance is not part of your Businessowners Policy (BOP). It must be purchased as a separate insurance policy. Each state has its own rules about where employers may buy workers comp insurance. In a few states all employers must buy their workers comp insurance from a state monopoly insurer, known as a state fund. In a number of other states, insurance may be purchased from the state fund or from private insurers. In the states that have them, state funds may serve as an insurer of last resort for businesses that cannot find coverage from a private insurer.

Required Insurance for Employers

Businesses with employees are required by law to pay for certain types of insurance: workers’ compensation insurance, unemployment insurance, and, depending on where the business is located, disability insurance.

Worker’s Compensation Insurance

Nearly every state has laws regarding worker’s compensation insurance. This insurance protects employees against lost income resulting from work-related illnesses or injuries. These insurance laws address amounts to be paid in, rehabilitation, retraining, beneficiaries, and medical payout limits.

Some states allow a business owner to purchase insurance through a commercial carrier or through the state Workers’ Compensation Insurance program. Check on your state government’s website to learn the requirements in your state and what options may be available to you to meet the requirements. For example, some state-facilitated programs may provide specific plans for sole proprietorship’s.

FACTORS THAT AFFECT YOUR PREMIUMS
Premiums for workers comp vary among the states. In states where benefits are more generous, premiums for workers comp insurance may be correspondingly greater. In most states, workers comp benefits continue even after the worker begins to collect Social Security and Medicare.

However, benefits are only one part of the equation. In some states with low benefits and costs, premiums may be high due to the inefficiency of the system for awarding benefits. The generally increasing cost of medical care impacts premiums as well. Although states are working to make changes, for the most part, workers comp insurance doesn’t have the types of cost control measures that have been applied to health insurance. Workers comp claimants do not have to pay deductibles. In many states they may visit as many doctors and specialists as they like. There is generally no requirement for doctors to prescribe generic rather than brand name drugs.

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USA State by State Workers Compensation Insurance Agencies